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| The prevalence, associated factors, and impact of urinary incontinence in pregnant and postpartum women in Nanjing, China: A cross-sectional study |
Xiaowei Yanga,b,*( ),Lynn Sayera,Sam Bassetta,Sue Woodwarda
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a King's College London, Department of Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London, United Kingdom
b Nanjing Vocational Health College, Department of Clinical Teaching and Research, Nanjing, China |
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Abstract Objective Urinary incontinence (UI) is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84% to 38.65%. This study was to assess the prevalence of UI, the associated factors, and the impact of UI on daily life in pregnant and postpartum women in Nanjing, China.
Methods The prevalence of UI and the impact of UI on life were assessed by the validated Chinese version of International Consultation on Incontinence Questionnaire-urinary incontinence-short form and the validated Chinese version of urinary incontinence quality of life. The associated factors were estimated by using logistic regression analysis.
Results UI affected 37.80% of pregnant women and 16.41% of postpartum women of the study population. Among the pregnant participants, the prevalence rates of stress UI, urge UI, and mixed UI were 25.77%, 4.47%, and 7.10%, respectively. Among the postpartum women, the prevalence rates of stress UI, urge UI, and mixed UI were 11.15%, 1.92%, and 2.69%, respectively. In both pregnant women and postpartum women, vaginal delivery had significantly increased the odds of reporting UI (p=0.007, p=0.003, respectively). The impact of UI on daily life was significantly greater in postpartum women compared to pregnant women especially in social embarrassment (p=0.000).
Conclusion The prevalence rates of UI were high in pregnant women in Nanjing, China. Vaginal delivery significantly increased odds of reporting UI. UI has a great impact on pregnant and postpartum women's life, especially in social embarrassment.
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Received: 06 January 2022
Available online:
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Corresponding Authors:
Xiaowei Yang
E-mail: xiaowei.yang@kcl.ac.uk
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Study flow chart.
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| Characteristic | Pregnant women (n=873) | Postpartum women (n=780) | | Agea, year | | 18-20 | 1 (0.11) | 0 | | 21-25 | 72 (8.25) | 75 (9.62) | | 26-30 | 443 (50.74) | 367 (47.05) | | 31-35 | 288 (32.99) | 261 (33.46) | | 36-40 | 59 (6.76) | 64 (8.21) | | Above 40 | 10 (1.15) | 13 (1.67) | | Educationa | | Primary school or below | 1 (0.11) | 2 (0.26) | | Junior or senior school | 78 (8.93) | 29 (3.71) | | University | 637 (72.97) | 547 (70.13) | | Postgraduate or above | 157 (17.98) | 202 (25.90) | | Job typea | | Mental labor | 605 (69.30) | 545 (69.87) | | Physical labor | 13 (1.49) | 16 (2.05) | | Other | 255 (29.21) | 219 (28.08) | | Body mass index, mean±SD, kg/m2 | 21.25±3.06 | 21.08±2.86 | | Gestational weeks or weeks after delivery, mean±SD | 35.8±4.22 | 8.8±1.8 | | Gestational stagea | | The first trimester | 9 (1.03) | NA | | The second trimester | 42 (48.11) | NA | | The third trimester | 822 (94.16) | NA | | Time after delivery, week | | 1-3 | NA | 35 (4.49) | | 4-5 | NA | 77 (9.87) | | 6-8 | NA | 318 (40.77) | | 9-10 | NA | 288 (36.92) | | Above 11 | NA | 62 (7.95) | | Number of deliveries | | Nulliparous | 531 (60.82) | 509 (65.26) | | Given birth more than once | 342 (39.18) | 271 (34.74) | | Parity, mean±SD | 1.53±0.76 | 1.5±0.7 | | Women had family history of urinary incontinencea | 12 (1.37) | 26 (3.33) | | Women experienced vaginal deliverya | 137 (15.69) | 372 (47.69) | | Smokea | | 0 | 870 (99.66) | 776 (99.49) | | 1 to 3 cigarettes a week | 2 (0.23) | 1 (0.13) | | 4 to 6 cigarettes a week | 0 | 0 | | 1 to 2 cigarettes a day | 0 | 0 | | 3 to 5 cigarettes a day | 1 (0.11) | 1 (0.13) | | 6 to 10 cigarettes a day | 0 | 1 (0.13) | | Above 10 cigarettes a day | 0 | 1 (0.13) | | Alcohol intakea | | 0 | 871 (99.77) | 775 (99.36) | | 1 to 3 glasses a week | 1 (0.11) | 2 (0.26) | | 4 to 6 glasses a week | 0 | 2 (0.26) | | 1 to 2 glasses a day | 0 | 0 | | 3 to 5 glasses a day | 0 | 0 | | 6 to 10 glasses a day | 1 (0.11) | 0 | | Above 10 glasses a day | 0 | 1 (0.13) | | Coffee intakea | | 0 | 825 (94.50) | 703 (90.12) | | 1 to 3 cups a week | 43 (4.93) | 57 (7.30) | | 4 to 6 cups a week | 0 | 10 (1.28) | | 1 to 2 cup a day | 4 (0.46) | 8 (1.03) | | 3 to 5 cup a day | 0 | 1 (0.13) | | Above 5 cup a day | 1 (0.11) | 1 (0.13) |
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Characteristics of the participants
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| Type | Participant, n (%)a | Women who have UI symptoms, n (%) | p-Value | | SUI | | Pregnant | 225 (25.77) | 225 (68.18) | | | Postpartum | 87 (11.15) | 87 (67.97) | | | UUI | | Pregnant | 39 (4.47) | 39 (11.82) | | | Postpartum | 15 (1.92) | 15 (11.72) | | | MUI | | Pregnant | 62 (7.10) | 62 (18.79) | | | Postpartum | 21 (2.69) | 21 (16.41) | | | Other types of UI | | Pregnant | 4 (0.46) | 4 (1.21) | | | Postpartum | 5 (0.64) | 5 (3.91) | | | UI | | Pregnant | 330 (37.80) | NA | X2=98.883; p=0.000 | | Postpartum | 128 (16.41) | NA |
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Prevalence rates of SUI, UUI, MUI, other types of UI, and UI.
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| ICIQ-UI-SF and I-QoL questions | Pregnant | Postpartum | p-Value | | Incontinence episodesa | | | X2=99.721; p=0.000 | | Never | 543 (62.20) | 552 (70.77) | | About once a week or less often | 199 (22.80) | 168 (21.54) | | Two or three times a week | 88 (10.08) | 38 (4.87) | | About once a day | 26 (2.98) | 16 (2.05) | | Several times a day | 15 (1.72) | 3 (0.38) | | All the time | 2 (0.23) | 3 (0.38) | | Amount of leakagea | | | X2=286.729; p=0.000 | | None | 543 (62.20) | 552 (70.77) | | Small | 325 (37.23) | 77 (9.87) | | Moderate | 5 (0.57) | 145 (18.59) | | Severe | 0 | 6 (0.77) | | Perceived impact of those reporting UI, mean±SD | 0.78±1.63 | 3.00±0.00 | Z=?8.079; p=0.000; | | ICIQ-UI-SF score, mean±SD | 2.24±3.11 | 7.20±2.88 | Z=?8.580; p=0.000 | | Impact on life (women who have the symptoms of UI)a | | | X2=31.253; p=0.000 | | Light | 274 (83.03) | 77 (60.16) | | Moderate | 52 (15.76) | 45 (35.16) | | Severe | 4 (1.21) | 6 (4.69) | | Social embarrassment score, mean±SD | 96.55±6.43 | 95.75±9.05 | Z=?9.542; p=0.000 | | Avoidance and limiting behavior score, mean±SD | 97.20±6.75 | 96.09±6.35 | Z=?4.000; p=0.000 | | Psychosocial impact score, mean±SD | 97.74±5.34 | 96.76±6.82 | Z=?7.413; p=0.034 | | I-QoL score, mean±SD | 97.27±5.52 | 96.29±6.57 | Z=?10.443; p=0.000 |
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The results from ICIQ-UI-SF and I-QoL score.
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| Risk factor | cOR | aOR | | Median (95% CI) | p-Value | Median (95% CI) | p-Value | | Pregnant women | | Family history of UI | 4.256 (1.144-15.830) | 0.031 | 3.627 (0.963-13.654) | 0.057 | | Experience of vaginal delivery | 1.734 (1.202-2.503) | 0.003 | 1.669 (1.153-2.417) | 0.007 | | Postpartum women | | Parity | 1.264 (0.992-1.610) | 0.058 | 1.251 (0.980-1.599) | 0.073 | | Experience of vaginal delivery | 1.827 (1.242-2.688) | 0.002 | 1.810 (1.229-2.665) | 0.003 |
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Logistic regression analysis of associated factors in pregnant women and postpartum women.
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